title: Cigarette, cigar, and pipe smoking and the risk of head and neck cancers: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium.
abstract: Cigar and pipe smoking are considered risk factors for head and neck cancers, but the magnitude of effect estimates for these products has been imprecisely estimated. By using pooled data from the International Head and Neck Cancer Epidemiology (INHANCE) Consortium (comprising 13,935 cases and 18,691 controls in 19 studies from 1981 to 2007), we applied hierarchical logistic regression to more precisely estimate odds ratios and 95% confidence intervals for cigarette, cigar, and pipe smoking separately, compared with reference groups of those who had never smoked each single product. Odds ratios for cigar and pipe smoking were stratified by ever cigarette smoking. We also considered effect estimates of smoking a single product exclusively versus never having smoked any product (reference group). Among never cigarette smokers, the odds ratio for ever cigar smoking was 2.54 (95% confidence interval (CI): 1.93, 3.34), and the odds ratio for ever pipe smoking was 2.08 (95% CI: 1.55, 2.81). These odds ratios increased with increasing frequency and duration of smoking (Ptrend ≤ 0.0001). Odds ratios for cigar and pipe smoking were not elevated among ever cigarette smokers. Head and neck cancer risk was elevated for those who reported exclusive cigar smoking (odds ratio = 3.49, 95% CI: 2.58, 4.73) or exclusive pipe smoking (odds ratio = 3.71, 95% CI: 2.59, 5.33). These results suggest that cigar and pipe smoking are independently associated with increased risk of head and neck cancers.
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, NC 27599, USA. andy_olshan@unc.edu
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authors.lastname: Franceschi
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authors.lastname: Wünsch-Filho
authors.forename: Leticia
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authors.lastname: Fernandez
authors.forename: Eleonora
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authors.lastname: Fabianova
authors.forename: Alexander W
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authors.lastname: Daudt
authors.forename: Luigino
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authors.lastname: Dal Maso
authors.forename: Maria Paula
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authors.lastname: Curado
authors.forename: Chu
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authors.lastname: Chen
authors.forename: Xavier
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authors.lastname: Castellsague
authors.forename: Marcos Brasilino
authors.initials: MB
authors.lastname: de Carvalho
authors.forename: Gabriella
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authors.lastname: Cadoni
authors.forename: Stefania
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authors.lastname: Boccia
authors.forename: Paul
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authors.lastname: Olshan
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology*; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: head and neck neoplasms; smoking